Occupational hand and wrist disorders among forestry workers: An exposed-control study to investigate preventive strategies.

BACKGROUND: In the arboriculture sector, some activities are still manually performed by forestry workers, which result consequently exposed to a high risk of developing muscle skeletal disorders. The Italian Compensation Authority reported an increase of work-related tendinopathies and carpal tunnel syndrome in loggers, but screening protocols are not available yet. OBJECTIVES: The objectives were: a) to evaluate the prevalence of tendinopathies and carpal tunnel syndrome in a sample of loggers and b) identify a sound screening approach. METHODS: 41 loggers and 41 paired control workers were recruited for a total of 164 hands. The protocol included 1) demographic data; 2) medical history; 3) identification of CTS symptoms through a questionnaire and a hand-chart; 4) upper limbs clinical examination; 5) Raynaud's diseases questionnaire; 6) wrists ultrasound; 7) NCS of the distal median nerve. RESULTS: The prevalence of tendinopathies was statistically significant only in the non-dominant hand (75, 5% in the exposed group and 53, 6% in the non-exposed group). The prevalence of CTS was 32, 2% in the exposed group and 15, 5% in the non-exposed group. The questionnaire had a sensitivity of 56, 7% and a specificity of 75%. The hand-chart had a sensitivity of 30% and a specificity of 92%. The clinical examination had sensitivity of 30% and specificity of 80%. The ultrasound had a sensitivity of 70% and a specificity of 56%. CONCLUSIONS: Loggers are a population at risk of occupational hand and wrist disorders. The hand-chart could be considered, together with the questionnaire, as the best secondary prevention tool to diagnose CTS.

Functional Neuroimaging in Irritable Bowel Syndrome: A Systematic Review Highlights Common Brain Alterations With Functional Movement Disorders.

Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by recurring abdominal pain and altered bowel habits without detectable organic causes. This study aims to provide a comprehensive overview of the literature on functional neuroimaging in IBS and to highlight brain alterations similarities with other functional disorders - functional movement disorders in particular. We conducted the bibliographic search via PubMed in August 2020 and included 50 studies following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines for systematic reviews. Overall, our findings showed an aberrant activation and functional connectivity of the insular, cingulate, sensorimotor and frontal cortices, the amygdala and the hippocampus, suggesting an altered activity of the homeostatic and salience network and of the autonomous nervous system. Moreover, glutamatergic dysfunction in the anterior insula and hypothalamic pituitary axis dysregulation were often reported. These alterations seem to be very similar to those observed in patients with functional movement disorders. Hence, we speculate that different functional disturbances might share a common pathophysiology and we discussed our findings in the light of a Bayesian model framework.

Left Bell's palsy following the first dose of mRNA-1273 SARS-CoV-2 vaccine: A case report.

Even though no definitive link has been established, Bell's palsy has been described as a potential side effect of SARS-CoV-2 mRNA vaccines in a few reports, and the US Food and Drug Administration has recommended strict surveillance of its occurrence in the vaccinated general population. We present the case of a previously healthy 35-year-old female patient who developed Bell's palsy 12 h after receiving the first dose of the mRNA-1273 vaccine. Her general practitioner performed the diagnosis, and corticosteroid treatment was initiated, with slow symptoms improvement. The neurologist's evaluation and a contrast-enhanced brain Magnetic Resonance Imaging revealed a subtle enhancement of the left facial nerve, confirming the diagnosis of Bell's palsy.

Cerebrospinal fluid glutamate changes in functional movement disorders.

The aim of this study was to assess cerebrospinal fluid (CSF) concentrations of specific amino acids using a high-performance liquid chromatography system in a sample of patients with functional movement disorders (FMDs) and in a sample of controls. CSF levels of glutamate were significantly lower in patients with FMD than in controls. This finding argues in favor of glutamatergic dysfunction in the pathophysiology of FMD.

Psychiatric Disorders in Alzheimer Disease With the Presenilin-1 L226F Mutation.

The presenilin-1 (PSEN1) L226F mutation has been linked to very early onset of prominent behavioral and psychiatric disturbances followed by cognitive decline within a few years. We report a novel case of early-onset Alzheimer disease that was originally diagnosed as psychotic depression in a patient with this gene mutation. We also compare our patient's clinical data to those of other cases of this mutation that have been described in the literature. Because atypical behavioral and psychiatric disturbances in young (<40 years) individuals can herald Alzheimer disease, a tight collaboration between psychiatrists and neurologists is crucial for an early diagnosis.

Respiratory dysfunction in Parkinson's disease: a narrative review.

The presence of respiratory symptoms in Parkinson's disease (PD) has been known since the first description of the disease, even though the prevalence and incidence of these disturbances are not well defined. Several causes have been reported, comprising obstructive and restrictive pulmonary disease and changes in the central ventilatory control, and different pathogenetic mechanisms have been postulated accordingly. In our review, we encompass the current knowledge about respiratory abnormalities in PD, as well as the impact of anti-Parkinsonian drugs as either risk or protective factors. A description of putative pathogenetic mechanisms is also provided, and possible treatments are discussed, focusing on the importance of recognising and treating respiratory symptoms as a key manifestation of the disease itself. A brief description of respiratory dysfunctions in atypical Parkinsonism, especially α-synucleinopathies, is also provided.

Bilateral ischemia of the insular cortex after high altitude climbing: A case report.

High altitude exposure could be related to neurological events such as stroke-like episodes, even if the exact pathogenic mechanism is still debated. We describe the case of a caucasian woman who had a bilateral insular ischemic stroke after a rapid ascent above 4000 m in which a secondary embolic dissemination due to a right insular stroke, maybe related to high altitude hemoconcentration, could be hypothesized. In our opinion a prolonged cardiac rhythm monitoring have to be considered especially when no other embolic sources are found and for lesions involving the insular cortex.